IDLIB, Syria: Nurses hover over a patient to insert a breathing tube as his condition suddenly deteriorates. ICU beds fill up almost overnight. As one patient dies of the coronavirus and is wheeled out, another is whisked in to take his place. An exhausted doctor leans against a wheelchair for a breather.
The pace is dizzying at the largest isolation hospital in Syria’s northwestern city of Idlib. There are no bombs falling outside and the wounded don’t crowd bloodstained corridors amid a shaky cease-fire in the country’s decade old civil war. Still, the intensive care unit staff is overwhelmed with beds full of elderly patients gasping for air.
COVID-19 infections in the last opposition-controlled territory in Syria have been increasing rapidly. Spared until July, the region is now recording 300-500 infections a day, and the number is rising fast.
The area, battered by repeated military offensives from the government of President Bashar Assad, is home to nearly 4 million people, most of them displaced and living in tent camps or unfinished buildings.
Infection rates jumped nearly twentyfold between September and October, the UN said. Since then, it has climbed 300 percent, with nearly 11,900 cases recorded by Nov. 16, up from 8,100 a week earlier.
The number of infections is probably much higher. Cities have been hit hardest, but workers fear the virus will take hold in overcrowded camps.
“There are many patients, most in very bad condition. We have no time to give them all they need,” said Aref Shabib, one of over 95 nurses and technicians in the 70-bed isolation hospital, one of two in the city of Idlib, now a virus hot spot.
The pandemic, which has severely tested even developed countries, is the biggest challenge yet for Syria’s health sector, already depleted by years of conflict. Authorities are pacing themselves, deploying equipment and supplies where needed in war-scarred areas.
Announcements of virus deaths on social media or mosque loudspeakers compete with posters honoring those killed in battle, with 95 fatalities linked to COVID-19.
As winter rains began, bringing with it renewed rumblings of war, fear is growing that exhausted medical teams may not be able to cope.
Nearly 17 percent of infections were among health workers, who were first to get the virus. At least three doctors and an administrator died. Medical workers who survived the battlefield find themselves fighting an invisible enemy that pushes their resilience to new limits.
Unlike the war wounded, an entire 24-hour shift can be devoted to just one COVID-19 patient, said Shabib, the ICU specialist.
“We could work for six or eight hours nonstop without even sitting down. It is very hard work,” he said.
In northwestern Syria, which has been outside government control for most of the last decade, dispersing aid is as complicated as the politics of the conflict.
According to the UN task force coordinating efforts, there are at least 142 ICU beds and 155 breathing machines in use in the area. The plan is to eventually have 219 ICU beds and 162 machines. Nearly 500 doctors and nurses are working in COVID-19 centers.
Seven of eight hospitals in northwestern Syria that are equipped to treat the virus are already overwhelmed.
“The increase in COVID infections, cases of hospitalization and nearing full occupancy of ICUs, brings us closer to a state of emergency,” said Salem Abdan, head of Idlib’s health directorate.